Fluoroscopic fracture apparatus



March 16 1926.

H. B. PHILIPS FLUOROSCOPI C FRAGTURIEIl APPARATUS 2 Sheets-Sheet 2 FiledApril 22, 1924 .MY NQ o INVENTOR Mm B ATTORNEY Patented Mar. 16, 1926.

g kiwi/1x21).l sra-rss- HERMAN B. PHILIPS, -NEW-YORK N; .Y.

FL'UOIROSCOPIC FRACTURE APPARATUS Applicationled April 2 2, 1924;'Serial No.` 708,108.l

Be' itknown that'li,A HERMAN BS PHILIPS, a'citizenof the UnitedlSta-tes, residing at NewY York city, borough. of Manhattan, in

the VcountyofNeW York and State of New York,l have invented certain newand useful Improvements in Fluoroscopic Fracture Apparatus, of whichythe followingz is a specification.

This invention relates to hospital apparatus or. surgical'appliances andhas partie# ularl'reference to mechanisms or apparatus for'the reductionof broken bones andthe detection or' correctionsv ofr` any malpositionor deformity incident to such cases.`

Ainong'theobjects of the invention is to provide ac oinb'iiied fracturelstretcher and table designed to reduce deformities or mal'-posit-ioii'of fragments of broken bones under fluoi'oscopicguidance,-both in horizontal andr vertical planes, and eithercalone` orsimultaneously; to ailord means forl traction on any limb or extremityatany'angle, and with any desired|` countertraction:orvrtractionorpressurelat any angle tothe main traction; to providemeansassetv forth inthe yforegoingjtoreduce' deformities from fractures `ordisease and retain" them inV any desired position While immobilizingfirmly in plaster. Vcasts. or splints; to provide: a stretcher'on;vvhichY a patientv maybe supported -notonly for the purpose of theappli-V cationv o ftheytraction and reducing operations above referredto but alsoupon which he may"bemoved for thel purpose of fluoroscopyorra'dio'graphy, but especially to provide! means whereby. the lobservation through fuoroscopy` or .the making of recor'ds through theradiographic or Roentgenograpliie'stepsmaybe practised at the saine timethat? the reduction of thepbones: or the like i'sftakingplaceso that theoperator may he guided in his operations by the k.visual resultsobtained; through' either of '..the means just referredto'. l. l stillVfurther ohjectoflthe invention is to provide" substantial'.facilities'for simultaneous use with the stretcher aforesaid'so as1jto .aifordeither. vertical or horizontal iiuorosjcopy or both at thezsaine timevWhile the' treatment ofthe limb is .in progress.

With the foregoing.andl other: objects in `viewrtlie.inventionconsists'in the` arrangement and combination' of-parts .hereinafterdescribed and claimedV andy While the invention is not restricted'Yto'thepexact/ details of construction disclosed or suggestedv` herein,still for the purpose of illustrating"a practicalA embodiment thereofreference is: had to the accompanying drawings,Y in which like referencecharacters designate thejsame 'parts inthe several views,` and'inFigurel isa side elevation showing one adaptation of my improvement.

Fig. 2vis aplan'view of the same.

Fig;v 3 isa sectional fdetail on the line 3;-3 Y,

of Fig. l. Y

Fig; 4 isa plan view ofa detail described inconnection with Fig. 5i eFig;v is a vertical detail partly inse-c;A tion of the crotch mechanism.

Fig. Gis adetail perspective' vievv` of the transformer mechanism forthe horizontal fluoi'oscopy, its#meansofsupport, and the liofertical andhorizontalscreens carried there'- Referring now more specifically tothedravvingsly shovvy a frame or'stretcher comprising tvvo side bars10,`twoend"bars 11,

and corner 'coimectionsf 12. These corner pieces may constitute or carryhandles 13 for manipulating the stretcher as such',V in

-a Well known manner. VThe side rails 10 andeither orboth ofthe enol-lrails fare provided vvith vertical holes llispacedat regularl intervalsfromv one` another. The/end rails'or at least one of them areopenendedforythe accommodatien onty slidable` rodsV4 15 which normally telescopeor maybe drawn o utvvard'tolany desired length andlocked as byineans ofaa-spring pin 16 or its equivalent through the adjacent corner pieces foriixing the position of the extensions. The-corner piecesy may havedoWnWardfextensions l2 serving as feet for supporting the stretcher.

17 indicatesl al'plate shown as, substantially rectangular and extendingacross the stretcher and supported at its Vends onk the side rails 10`and ,along which they plate is movable endWiseL ofthe device, the ends"of around: the axis of the pedestal to lie either longitudinallyor'tiansversely ofthe stretcherY accordingv to its immediatel purpose.Q0 indicates the crotch piece or pin detachably connected as by threads21 1n the upper end et the pedestal and may serve as a binding means orloclr for holding the disk from rotation. The upper end ot the crotchpin is screw threaded to receive a stein 22 :tor holding one or morehorizontally extending arms Q3 having slides or brackets 2li tor suchpurposes as support ing traction or countcrtraetion means or bandages orslings such asindicated at 25. The disk 18 may be used as a support forthe hips as shown or may be used for other purposes such as a clamp torthe patients shoulder and for this purpose the patient may be supportedat the saine level as indicated in Fig. 1 or may be lowered to the planeof the stretcher itranie. ln the former case the disk or shel't 1S maybc clamped between the crotch pin and the stem 22 or it may be otherwiseattached to the pedestal.

2G indicates a bed plate ot wood oil any suitable composition and whichlike the plate 17 is preferably transparent to lsloeut gen rays. llhehed plate Q6 is reetzuigular and supported 'for cndwise adjustment uponthe rails lO. Pillows or padding 27 will be employed lor their usualpurpose in bolsterine` up the patientai; any desired point.

The pedestal is connected adjustably to Y the plate 17 as by means o'tbolts 2S cooperating with slots S9. The plate 17 is held from endwisemovement under traction on the patient along the stretcher as by meanso't' clamps 30 adjustable along the rails 10.

In connection with the stretcher i'raine or extensions thereo't l employone or more traction units 31 cach comprising an arm adjustablevertically in a clamp 33 carried by either end or side bar ot theiframe, though usually it is connected to the foot rail 11 for thereduction oit a broken lee". The unit includes also a nut or head Silalong which a threaded shank or screw is slidahle but held 'fromrotation by any well known ineans such as a spline. The traction isproduced by means o't a hand Wheel 36 or its equivalent co-operatingwith the threaded screw and bearing against the head 3l in a well knownmanner. The extremity, as the toot, ot the patient is secured, as bybandaging or lacing, to a yoke or clamp piece 37 having universal balljoint connections in a clamp 38 fixed to the adjacent end oit the screw35. The open structure et the yoke `provides `for easy access to thepatients extremity 'for the purpose indi cated. The clamp 33 may besecured to the rail either by means gripping the same or by means otpins passing therethrough and through the holes 111-. For attaching theunit or any olf them to the 'traine extensions 15 a clamp 33 may beemployed. This provides an anchorage for the traction unit ported ormanipulated in any convenientv manner.

As an illustration ot the many accessories., l indicate at 39 a torlnoit clamp adapted especially lor connection to and interloclo ing withthe perforated laile oli the stretcher. lllatending upward from thisClamp and gripped thereto by a hand piece l0 is a post all whichobviously may be adj usted around its own axis in the clamp as may bedesired. .fit the top oi this post is a huh d2 in which is adjustablymounted a horizontal arni lil and locked as by means oit a set screw/l-l. t one end oi' this arm is a clamp or joint l5 which carries au arm1 1'6 :u'ljustahle in any desired angle with respect in the arni il?)and in all other respects taku ing into consideration the manner otconnectine` the arln 4? to the post, and the post in turn to the clamp39. The arm 116 may be provided with any suitable 'lorin of yoke i7 'forusc ttor traction7 countertraction, or other analogous purposes, andhaving practically universal joint connection with the. inain supporthas a wide range of adjustnient anywhere along` the stretcher and at anyposition alter being so adjusted Another important 'feature of myinechauisin comprises a. table having a top 48, corner uprights or legs4:9, and a plurality ot longitudinal bars not only for stiening thetable. but 'tor purposes soon to appear. Some of these hars, asindicated at :10. extend lengthwise along the sides of the tableapproximately midway between the floor and the top 418 and in the samehorizontal plane. 51 indicates conventionally an `Ill-ray apparatus ortransformer arranged with its axis in vertical position and mounted slidably upon a pair of transverse rails 52, said rails being mounteduponrunners or shoes 5? co-operating directly With the rails 50. so thatthe apparatus as a whole may be moved bodily endwisc of the rails 50 andalso independently of the rails 50 transversely of the table along therails 52 so as to bring the transformer 51 beneath any point or part ofthe table top. The action et this transformer is upward or verticalthrough the table top and through the patient. Hence it is designed togive an image directly upon the horizontal screen 51n or for the makingof a radiograph upon a plage similarly located above the patient.

At either side of the table is a `carlil() riage 54 comprising a pair ofvertical hollow posts 53 with any suitable tie bars 56 between them.This carriage is mounted upon a rail 58 near the floor. The posts at anyconvenient place as just below the table top are provided with hangers59 which eX- tend beneath the table top and carry pairs of rollers 60which embrace a bar 61 eX- tending between the corner posts 49 of thetable. Thus the carriage 54 is movable freely along the rails 58 and 61and consequently at any desired position along the table from one end tothe other. 62 indicates a second X-ray tube or transformer arranged withits axis in horizontal position and supported upon a pair of horizontalarms 63 extending through a similar number 0f sleeves 64- slidable ormovable up and down along the posts 55. The'arms 63 are movablelaterally so as to position the transformer 62 at any desired positionwith respect to the center of the table and it of course is movablealong the posts as well as with thc posts or carried longitudinally ofthe table. This transformer is designed to throw the image horizontallywhere it may be observed on the vertical screen 62L or a plate may bemade at such position for a radiograph. As shown in Fig. 6 the screensare connected to a frame 65 slidable horizontally in guide ways 66 atthe top of the transformer 62 so that the screen 5la may be moveddirectly over the transformer 62. The screen 62a is hinged at 67 to theother screen or itsv frame and may be swung upward into the same planeas the screen 51a where it may be locked by spring catches 68 or theirequivalent. With the two screens adjusted as shown in Fig. 6 theoperator or surgeon may observe fluoroscopically on either or both ofthe screens simultaneously the image thrown upward and horizontally fromboth of the transformers while at work upon the patient. Obviously,after the reduction has been completed the transformer 62 may be movedout of the way for the purpose of facilitating the bandaging of theextremity. The transformer 62 is counterbalanced in a well known mannerby the use of suspending cables 69 to the other ends of which arecounterweights 70 movable within the posts.

From the foregoing it will be appreciated that the objects aboveindicated are attained in a practical apparatus, and by means of theuniversality of the various devices and connections the extremity or anypart of the patient can be put and kept in any position, such asflexion, extension, inversion, eversion, abduction, or adduction. Itwill be appreciated also that the apparatus, `having referenceespecially to the fluoroscopic facilities, may be utilized for generaldiagnosis, as for the localization of any foreign body or particles thatmay seem to be present in the body, and independently of reduction offractures.

I claim:

1. Apparatus for making fluoroscopic observations, which includetransformers arranged with their aXes at an angle to each other, andscreens to co-operate with the .individual transformers to permit apatient to be observed from a plurality of directions without changingthe adjustment of the apparatus, said screens being secured together atan angle, one of said screens having movable engagement with one of thetransformers to permit the screens tobe nested close against thetransformer or to'be moved outwardly therefrom for the taking ofobservations in conjunction with saidtransformers. v 2. Apparatus, forthe making of fiuoroscopic observations which include transformersarranged with their axes at an angle to each other, and screens toco-operate with the individual transformers to permit a patient to beobserved from a plurality of directions without changing the adjustmentof the apparatus, one of said transformers carrying a plurality ofscreens secured at an angle to each other and operative in connectionwith one of said screens, while the other transformer is operative inconnection with the other screen.

In testimony whereof I afx my signature.

HERMAN B. PHILIPS.

